O fruto proibido, um caso de alergia oral / The forbidden fruit, a case of oral allergy

Trinta a 60% das alergias alimentares em adolescentes e adultos são associadas à alergia ao pólen e estão incluídas na síndrome pólen-frutas (SPF). Esta síndrome é caracterizada por sintomas alérgicos provocados pela ingestão de frutas ou vegetais frescos em pacientes com rinite/rinoconjuntivite alérgica sazonal. Os autores apresentam o caso clínico de um adolescente que após sensibilização primária através de pólens de gramíneas e oliveira manifestou posteriormente, por reatividade cruzada, sintomas de alergia oral com a ingestão de frutas frescas. Após recurso ao método de diagnóstico Immuno-Solid-Phase Allergen Chip (ISAC) verificou-se que as profilinas foram as proteínas responsáveis pela reatividade cruzada.

In adolescents and adults, 30% to 60% of food allergies are associated with pollen allergy and are included in the pollen-food syndrome (PFS). This syndrome is characterized by allergic symptoms elicited by the ingestion of fresh fruits or vegetables in patients with seasonal allergic rhinitis/rhinoconjunctivitis. The authors present the clinical case of an adolescent who, after primary sensitization to grass and olive tree pollens, subsequently manifested by cross-reactivity symptoms of oral allergy with the ingestion of fresh fruit. After diagnostic workup with the Immuno- Solid-phase Allergen Chip (ISAC) assay, profilins were identified as the proteins responsible for the cross-reactivity.

Granos de polen anemófilos: sensibilización en pacientes alérgicos / Anemophilic pollen grains: sensitization in allergic patients

A nivel mundial, los aeroalérgenos más frecuentes causantes de enfermedades alérgicas son los granos de polen anemófilos. Estos han sido capaces de desencadenar crisis que han reflejado una elevada morbilidad. En Cuba los estudios de sensibilización a granos de polen han sido escasos. Con el objetivo de determinar la sensibilización a granos de polen en pacientes alérgicos y su relación con la presencia de enfermedades alérgicas, se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, de marzo a junio del 2019. La muestra se constituyó de 33 pacientes con asma, rinitis, rinoconjuntivitis alérgica, dermatitis atópica y conjuntivitis alérgica. A todos los pacientes se les realizó historia clínica alergológica y prueba cutánea por punción con extractos alergénicos de: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucaliptus sp. Se aplicaron las frecuencias absolutas, porcientos, desviación estándar, promedio, edad media y test de Spearman para su análisis. La edad media de la muestra fue de 36,9 años, con predominio de mujeres. Más del 50por ciento de los pacientes presentaron sensibilización a granos de polen; y de ellos, el 24,24por ciento resultaron polisensibilizados. El mayor porcentaje de sensibilización fue a Cynodon dactylon. La rinitis alérgica fue la enfermedad que prevaleció en la población estudiada(AU)

Nowadays, the most frequent aeroallergens causing allergy diseases have been anemophilous pollen grains. They have been able to triggers crises that have reflected a high morbidity. In Cuba, studies of sensitization to pollen grains have been scarce. The objective of our research was to determine the sensitization to pollen grains in allergic patients and its relationship with the presence of allergic diseases. A non-randomized, descriptive, cross-sectional, observational study was conducted from March to June 2019. The sample consisted of 33 patients with asthma, allergic rhinitis, rhinoconjunctivitis, atopic dermatitis and allergic conjunctivitis. All patients underwent allergic history and skin prick test testing with allergenic extracts of: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucalyptus sp. Absolute frequencies, percentages, standard deviation, mean, average age, and Spearman´s test were applied for analysis. The average age of the sample was 36.9 years, with a predominance of women. More than 50percent of the patients presented sensitization to pollen grains; of them, 24.24percent polysensitized. The highest percentage of sensitization was to Cynodon dactylon. Allergic rhinitis was the disease that prevailed in the population studied(AU)

Diretriz Latino-americana sobre o Diagnóstico e Tratamento da Alergia Ocular ­ Em nome da Sociedade Latinoamericana de Alergia, Asma e Imunologia (SLAAI) / Latin American Guideline on the Diagnosis and Treatment of Ocular Allergy ­ On behalf of the Latin American Society of Allergy, Asthma and Immunology (SLAAI)

A alergia ocular, também conhecida como conjuntivite alérgica (CA), é uma reação de hipersensibilidade mediada por imunoglobulina E (IgE) do olho desencadeada por aeroalérgenos, principalmente ácaros da poeira doméstica e pólen de gramíneas. Os sintomas geralmente consistem em prurido ocular ou periocular, lacrimejamento e olhos vermelhos que podem estar presentes durante todo o ano ou sazonalmente. A alergia ocular tem frequência elevada, é subdiagnosticada e pode ser debilitante para o paciente. É potencialmente danosa para a visão, nos casos em que ocasiona cicatrização corneana grave, e na maioria dos pacientes associa-se a outros quadros alérgicos, principalmente rinite, asma e dermatite atópica. É classificada em conjuntivite alérgica perene, conjuntivite alérgica sazonal, ceratoconjuntivite atópica e ceratoconjuntivite vernal. O diagnóstico procura evidenciar o agente etiológico e a confirmação se dá pela realização do teste de provocação conjuntival. O tratamento baseia-se em evitar o contato com os desencadeantes, lubrificação, anti-histamínicos tópicos, estabilizadores de mastócitos, imunossupressores e imunoterapia específica com o objetivo de obter o controle e prevenir as complicações da doença.

Ocular allergy, also known as allergic conjunctivitis, is an immunoglobulin E-mediated hypersensitivity reaction of the eye triggered by airborne allergens, primarily house dust mites and grass pollen. Symptoms usually consist of ocular or periocular itching, watery eyes, and red eyes that may be present year-round or seasonally. Ocular allergy has a high frequency, is underdiagnosed, and can be debilitating for the patient. It is potentially harmful to vision in cases of severe corneal scarring, and in most patients, it is associated with other allergic conditions, especially rhinitis, asthma, and atopic dermatitis. It is classified as perennial allergic conjunctivitis, seasonal allergic conjunctivitis, atopic keratoconjunctivitis, and vernal keratoconjunctivitis. Diagnosis seeks to identify the etiologic agent, and confirmation is given by conjunctival provocation testing. Treatment is based on avoiding contact with triggers, lubrication, topical antihistamines, mast cell stabilizers, immunosuppressants, and specific immunotherapy with the aim of achieving control and preventing disease complications.

Molecular diagnosis and immunotherapy selection in a Portuguese population sensitized to grass and olive pollens / Diagnóstico molecular e seleção de imunoterapia numa população portuguesa sensibilizada ao pólen de gramíneas e de oliveira

Introduction: Phleum pratense (Phl p) and Olea europaea (Ole e) are common allergenic pollen. Objectives: To describe the sensitization patterns to Phl p and Ole e allergens in a subset of allergic rhinitis patients with positive skin prick tests (SPTs) to these pollens and compare the allergen immunotherapy (AIT) choice before and after determination of molecular components. Methods: Candidates to pollen immunotherapy with positive SPTs to both Phl p and Ole e were recruited. All of them underwent an SPT with a panel of aeroallergens and measurements of serum specific IgE (sIgE) to Phl p, Ole e, Phl p1, Phl p5, Phl p7, Phl p12, Ole e1, Ole e7, and Bet v2. Results: Forty adults were included. Of these, 83% and 65% were sIgE-positive to Phl p and Ole e, using the 0.35 kUA/L and 0.70 kUA/L cut-offs, respectively. Moreover, 42.5% of patients had positive sIgE to Phl p1 and/or Phl p5, 2.5% only to Ole e1, and 47.5% to both (0.35 kUA/L cutoff). By increasing the cut-off to 0.7 kUA/L, 55% of patients were sensitized to Phl p1 and/or Phl p5, and no patient was sensitized only to Ole e1. After component-resolved diagnosis, AIT choice was changed in 15 (37.5%) patients, with a decrease in the number of prescriptions of AIT with both grass and olive pollens and with olive alone, together with an increase in the prescriptions of AIT with grass pollen alone. Conclusion: Genuine sensitization to Olea europaea was reduced, and the sensitization patterns were heterogeneous. Knowledge of pattern of sensitization to molecular components changed immunotherapy prescription in more than one third of the patients.

Introdução: Os polens de Phleum pratense (Phl p) e de Olea europaea (Ole e) são fontes alergênicas comuns. Objetivos: Descrever os padrões de sensibilização aos alergênios destes dois polens num subconjunto de pacientes com rinite alérgica polínica e comparar a escolha de imunoterapia, antes e depois da determinação de alergênios moleculares para Phl p e Ole e. Métodos: Foram recrutados candidatos para imunoterapia com polens, com testes cutâneos positivos para Phl p e Ole e. Todos realizaram um painel de testes em picada a aeroalergênios e determinação de IgE séricas específicas para Phl p, Ole e, rPhl p1, rPhl p5, rPhl p7, rPhl p 12, rOle e 1, nOle e 7, rBet v2. Resultados: Foram incluídos 40 adultos. Em relação à sIgE para Phl p e Ole e, 83% e 65% dos pacientes apresentaram positividade para ambos, usando o cut-off de 0,35 kUA/L e 0,70 kUA/L, respectivamente. A positividade para Phl p1 e/ou Phl p 5 foi encontrada em 42,5%, para Ole e 1 apenas em 2,5%, enquanto 47,5% apresentaram sIgE positivo para ambos (cut-off corte de 0,35 kUA/L). Aumentando o cut-off para 0,7 kUA/L, 55% foram sensibilizados para Phl p1 e/ou Phl p5, nenhum paciente foi sensibilizado apenas para Ole e 1. Após a determinação dos alergênios para os componentes moleculares, a escolha de imunoterapia foi alterada em 15 (37,5%) pacientes, com uma diminuição no número de vacinas para Phleum + Olea e apenas para Olea e um aumento na prescrição de vacinas para Phleum. Conclusão: A sensibilização genuína do Olea europaea foi reduzida e os padrões de sensibilização foram heterogêneos. O conhecimento da sensibilização aos componentes moleculares dos alergênios mudou a prescrição de imunoterapia em mais de um terço dos pacientes.

Aerobiología de polen del olivo en las ciudades de Tacna y Arica y su relación con las enfermedades alérgicas respiratorias / Olive pollen aerobiology in Tacna and Arica cities and it is relation with the allergic respiratory diseases

Medir la concentración del polen en la atmósfera se ha convertido en objeto de interés a nivel mundial debido al aumento de las enfermedades alérgicas, ya que en muchas personas es causa de polinosis. Objetivos: se centró en la elaboración de un calendario de polen del olivo, basado en medir su concentración en las ciudades de Tacna (desde 2015 al 2018) y Arica (periodo 2018), y determinar la prevalencia de resultados positivos para extracto alergénico de polen del olivo en pacientes con síntomas de rinitis y/o asma provenientes de las ciudades de Tacna y Arica (periodo 2015-2018). Métodos: Se midió la concentración de polen, mediante el método volumétrico tipo Hirst, según estándares establecidos por el comité de aerobiología de la Sociedad Española de Alergología e Inmunología Clínica (SEAIC). Se incluyó una muestra total de 350 sujetos con síntomas respiratorios (200 de Tacna y 150 de Arica). Resultados: En Tacna, en 2015, 2016, 2017 y 2018, la concentración máxima de polen de olivo fue de 246 granos/m3 ; 110 granos/m3 ; 78 granos/ m3 y 688 granos/m3 respectivamente. En Arica en 2018, la concentración máxima de polen del olivo fue de 318 granos/ m3 . Se encontró que un 34% (68/200) y un 28% (42/150) de sujetos con síntomas respiratorios estaban sensibilizados u obtuvieron pruebas positivas al extracto de polen del olivo en sujetos de las ciudades de Tacna y Arica respectivamente. Conclusión: En ambas ciudades las concentraciones máximas de polen del olivo se encontraron principalmente entre los meses de septiembre a noviembre, siendo octubre el mes de mayores conteos. Se identificó sujetos alérgicos por test cutáneo al polen del olivo en las ciudades de Tacna y Arica.

The measurement of the concentration of pollen in the atmosphere has become an object of interest worldwide for the increase of allergy diseases, since in many people it is the cause of pollinosis. Objectives: focused on the elaboration of a calendar of olive tree pollen based on the measurement of the pollen concentration in Tacna (since 2015 to 2018) and Arica (period 2018) cities, and to determine the prevalence of positive results for allergenic extract of olive pollen in patients with symptoms of rhinitis and / or asthma, who came from Tacna and Arica cities (period 2015 to 2018). Methods. The pollen concentration was measured using the volumetric method according to standards established by the Aerobiology Committee of the Spanish Society of Allergology and Clinical Immunology (SEAIC), we included 350 subjects (200 from Tacna and 150 from Arica). Results: In Tacna, in 2015, 2016, 2017 and 2018, the maximum concentration of olive pollen was 246 grains/m3; 110 grains/m3; 78 grains/m3 and 688 grains/m3 respectively. In Arica in 2018, the maximum concentration of olive pollen was 318 grains/m3. We found 34% (68/200) and 28% (42/150) were sensitized or results positive test to the olive pollen extract in subjects with respiratory symptoms from Tacna and Arica cities respectively. Conclusion: The olive pollen in the atmosphere of Tacna and Arica is mainly concentrated in the months of September to November, being October the month with higher count. Allergic subjects were identified by skin test to olive pollen in Tacna and Arica cities.

Controle ambiental: prevenção e manejo das doenças atópicas / Environmental control: prevention and management of atopic diseases

A asma é uma das doenças crônicas mais prevalentes no mundo, sendo que 50% a 80% dos pacientes apresentam o fenótipo alérgico. A asma resulta da interação entre predisposição genética e exposição ambiental. Os aeroalérgenos perenes, especialmente os ácaros da poeira doméstica, são considerados um dos responsáveis pelo aumento da prevalência da asma em todo mundo. O controle ambiental é uma das medidas necessárias para o tratamento e controle da asma.

Asthma is one of the most prevalent chronic diseases worldwide, and 50 to 80% of affected patients have the allergic phenotype. Asthma results from the interaction between genetic predisposition and environmental exposure. Perennial aeroallergens, especially household dust mites, are considered one of the reasons for the increase in the prevalence of asthma worldwide. Environmental control is a necessary measure to treat and control asthma.

Effect of cigarette smoke on counts of immunoreactive cells to eotaxin-1 and eosinophils on the nasal mucosa in young patients with perennial allergic rhinitis / Efeito do tabagismo nas contagens de células imunorreativas a eotaxina-1 e eosinófilos na mucosa nasal em pacientes jovens com rinite alérgica perene

Abstract Introduction: In teenagers with perennial allergic rhinitis, exposure to tobacco cigarette smoke increases the count of eosinophils in the nasal mucosa; the recruitment of eosinophils arises from the combined action of a number of cellular and molecular signals, including eotaxin. Objective: To assess the effect of exposure to tobacco cigarette smoke on the count of immunoreactive cells to eotaxin-1 and eosinophils on the nasal mucosa of children and teenagers with perennial allergic rhinitis. Methods: In a cross-sectional study, forty-four patients were evaluated (aged 7-19 years old): 22 with and 22 with no exposure to tobacco cigarette smoke. After replying to 2 validated questionnaires, on Asthma and Allergies in Childhood and on the severity of nasal symptoms, nasal mucosal samples were obtained by scraping the middle one-third of the inferior turbinates. Then counts of immunoreactive cells to eotaxin-1 and eosinophils were assessed by immunohistochemistry. Results: Patients with exposure to tobacco cigarette smoke showed higher cell counts of both eotaxin-1 and eosinophils than patients with no exposure to the smoke, with no correlation between the two variables. However, both counts, of eotaxin-1 and eosinophils, were related to the cotinine/creatinine ratio. Conclusions: Exposure to tobacco cigarette smoke can increase eotaxin-1 and the count of eosinophils in the nasal mucosa of young patients with perennial allergic rhinitis.

Resumo Introdução: Em adolescentes com rinite alérgica perene, a exposição à fumaça do cigarro de tabaco aumenta a contagem de eosinófilos na mucosa nasal. O recrutamento de eosinófilos surge da ação combinada de alguns sinais celulares e moleculares, inclusive a eotaxina. Objetivo: Avaliar o efeito da exposição à fumaça do cigarro de tabaco na contagem de células imunorreativas a eotaxina-1 e eosinófilos na mucosa nasal de crianças e adolescentes com rinite alérgica perene. Método: Em um estudo transversal, 44 pacientes foram avaliados (entre sete e 19 anos): 22 com e 22 sem exposição à fumaça do cigarro de tabaco. Depois de responder a dois questionários validados, sobre asma e alergias na infância e sobre a gravidade dos sintomas nasais, as amostras de mucosa nasal foram obtidas por meio de raspagem do terço médio das conchas inferiores. Em seguida, as contagens de células imunorreativas para eotaxina-1 e eosinófilos foram avaliadas por imuno-histoquímica. Resultados: Os pacientes com exposição à fumaça do cigarro de tabaco apresentaram contagens de células mais elevadas tanto para eotaxina-1 como para eosinófilos em comparação com os pacientes sem exposição à fumaça, sem correlação entre as duas variáveis. No entanto, ambas as contagens, de eotaxina-1 e eosinófilos foram relacionadas com a razão cotinina/creatinina. Conclusões: A exposição à fumaça do cigarro de tabaco pode aumentar a eotaxina-1 e a contagem de eosinófilos na mucosa nasal de pacientes jovens com rinite alérgica perene.

ESTUDIO DE LA SENSIBILIZACIÓN POR AEROALÉRGENOS CON ESPECIAL ENFOQUE EN LA POLINOSIS COMO FACTOR DE SENSIBILIZACIÓN / Sensitizen by aeroalergens study with special focus on polinosis as sensitizen factor

Fundamento. Las alergias son importantes en Salud Pública; entre distintos tipos, la sensibilidad polínica (SP), en su forma de hipersensibilidad a pólenes, son patologías que afectan a parte de la población. Objetivo. Valorar la importancia del problema de SP en la región y relacionarlas con rinitis, asma, valores de IgE y otras alergias. Lugar de aplicación. Servicio Cátedra de Alergia e Inmunología (SAEI) del Hospital Nacional de Clínicas (HNC), Región Centro del País. Diseño. Estudio de corte. Estudio descriptivo útil para el administrador sanitario ya que permite determinar la carga que significa la enfermedad en la población. Permite conocer la prevalencia (P) de enfermedad. Población. Se analizaron historias clínicas (HC) de los pacientes que concurrieron al SAEI, ubicado en Córdoba capital. Método. Se procesaron las HC de los pacientes que acudieron al SAEI durante los años 2008-09 y a los que se les realizó el prick test, usando el programa Epi-Info 2000 versión 3.3.2. Se las analizó estadísticamente determinando Chicuadrado e intervalo de confianza. Resultados. La P de SP fue de 51,96%. Del total de la muestra, el 24,24% era monosensibilizado el 12,50% de estos lo era a pólenes. Del 75,76% de la muestra restante (polisensibilizado), el 65,33% estaba sensibilizado a pólenes. Conclusión. Analizando la P obtenida se desprende que las SP constituyen una problemática que afecta a más de la mitad de la población estudiada. También se observó que dicha problemática tiene, para la mayoría de los pacientes, una comorbilidad asociada a otros tipos de alergia. (AU)

Background. Allergies are important in Public Health, among the different types Pollen sensitivity, as hypersensitivity to pollen, are pathologies affecting part of the population. Objective. To appreciate the importance of the Pollen sensitivity problem in our region and to relate them to Rhinitis, Asthma, IgE values, and other allergies. Setting. Allergy and Immunology Service (AAIS) of the Hospital Nacional de Clínicas (HNC), in Córdoba city, Central Region of the country. Design. A Cross-sectional study was developed. This is a descriptive study of usefulness for the healthcare administrator because it allows estimating the disease burden significance on the population. It lets to know the sickness Prevalence (P). Population. Clinical Histories (CH) of the patients that attended the AAIS, located in Córdoba city were analyzed. Methods. CH of the patients that attended the AAIS during the years 2008 and 2009 and that the Prick Test was carried out, were processed by using the 2000 Epi-Info Program, 3.3.2. version. Statistically, Chi-square and Confidence Interval were calculated. Results. The Prevalence of Pollen sensitivity was 51.96%. From the total sample, 24.24% was monosensitized patients. Among them, 12.5% were monosensitized to pollens. The rest of the sample (75.76%) were poly-sensitized, from these, 65.33% were sensitized to pollens. Conclusion. Analyzing the obtained Prevalence emerges that Pollen sensitivity represent a problematic that affect more than a half of the studied population. Also it was observed that the pathology presented a comorbidity associated to other types of allergy produced by mites or fungus, among others, for the majority of the patients.(AU)

Google trends, una herramienta útil para detectar la presencia de polen atmosférico / Google trends, useful tool in airborne pollen detection

La polinosis es una de las alergias más comunes en el mundo, condicionando de manera directa la calidad de vida de la población, siendo la polinosis al olivo una de las más frecuentes en zonas de clima Mediterráneo. La previsión de los niveles de polen en la atmósfera se ha convertido en un objetivo fundamental para alergólogos y aerobiólogos, tratando de prevenir los síntomas de la polinosis. Google trends es una herramienta desarrollada por Google, que nos facilita información acerca de la dinámica de búsquedas de los usuarios a través de internet. Como objetivo principal de este trabajo se pretende realizar un valoración preliminar de la utilidad de esta herramienta para detectar la presencia de polen en la atmósfera y para explorar el impacto de polinosis entre la población.Para alcanzar dichos objetivos se han empleado datos aerobiológicos sobre concentración de polen de olivo en la atmósfera de Córdoba (España) y datos sobre tendencias de búsqueda en el buscador Google de las palabras ôAlergiaõ, ôPolenõ y ôOlivoõ. Se ha observado una elevada correlación y relación geográfica entre la tendencia de búsquedas de palabras relacionadas con polinosis y las concentraciones reales de polen atmosférico. Esta herramienta posee una gran potencial en la lucha contra la polinosis, ya que permite conocer información instantánea acerca de los síntomas en la problación, a diferencia de los métodos tradicionales que presentan un desfase de la información. De este modo, el presente trabajo ofrece evidencias acerca del potencial de Google trends para detectar la presencia de aeroalérgenos y para estudiar el impacto de la polinosis...

Pollinosis is one of the most extended allergies in the world, determining directly the quality of life of the population. Airborne pollen forecasting has become a key objective for allergists and aerobiologists trying to prevent the symptoms of hay fever. Google trends is a tool developed by Google, which provides information about the dynamics of user searches through internet. The main aim of this work is to conduct a preliminary assessment of the usefulness of this tool to detect the presence of large concentrations of pollen in the atmosphere and to explore the impact of pollinosis among the population.To achieve these objectives, the analysis is based on data for olive pollen concentrations in the atmosphere of Cordoba (Spain) and search counts in Google of the words "Allergy", "Pollen" and "Olive". We observed a high correlation and a high geographic relationship between the number of searches for words related to pollen allergy, and the actual concentrations of atmospheric pollen. This tool possesses a great potential in the fight against allergy because it can provide instant and on-line information about symptoms in population, unlike traditional methods that have a mismatch of information. Thus, the present study provides evidence about the potential of Google trends to detect the presence of aeroallergens and to study the impact of pollinosis...

Masticatory Changes in Oral Breath Secondary to Allergic Rhinitis: Integrative Review

Introduction: The III Brazilian Consensus on Rhinitis (2012) defines allergic rhinitis as a nasal mucosa inflammation, mediated by immunoglobulin E, after exposure to allergens. The classic signs and symptoms of allergic rhinitis are nasal obstruction, watery rhinorrhea, sneezing, and nasal itching, often reversible either spontaneously or with treatment, and mouth breathing (breathing predominantly through the mouth, regardless of the cause, due to a nasal breathing impairment) in some cases. Objective: To evaluate the literature on masticatory changes in children with mouth breathing due to allergic rhinitis. Methods: We conducted a search of the past 10 years, at Bireme and MEDLINE databases, for articles that covered masticatory changes in children with mouth breathing secondary to allergic rhinitis. Results: We found 1,986 articles, including 15 repeated in databases, but only two articles met the inclusion criteria fully. Discussion: We found few studies to answer the question raised in this review, and those studies have some methodological limitations. Most articles claimed no have statistically significant differences in masticatory changes in this population. Conclusion: A better controlled study (isolating diseases, exposure time), with a larger sample (sample calculation appropriate), would be necessary to examine such changes...

Utilidad de los péptidos 33 y 38 de Lolium perenne en la inmunoterapia de la rinitis polínica / Utility of the peptides 33 and 38 of Lolium perenne in immunotherapy of hayfever

Se aislaron y caracterizaron péptidos del polen de la gramínea Lolium perenne por métodos fisicoquímicos, se estudiaron sus propiedades bioquímicas e inmunológicas, tanto en el conejo como en humanos atópicos que sufrían de rinoconjuntivitis estacional producida por dicho polen, y se presentan los hallazgos inmunoserológicos luego de 3 años de inmunoterapia específica con los péptidos 33 y 38 obtenidos, que resultaron ser los más significativos en la composición fisicoquímica del polen.

Peptides isolated from the Lolium perenne pollen were submitted to several chemical and immunological procedures to establish their antigenicity. Immunotherapy with peptides 33 and 38 showed high potency to develop specific IgG blocking antibodies which correlated with statistical clinical improvement.

Asociación entre los valores de Rantes y la clínica en pacientes con rinitis alérgica / Association between rantes values and the clinical aspect in patients with allergic rhinitis

Objetivo: Determinar los valores de Rantes, después de la exposición a ácaros, para evaluar su asociación con la escala ARIA, en el grupo de pacientes seleccionado. Diseño: Estudio de corte transversal. Materiales y métodos: Se incluyeron 17 pacientes que consultaron por rinitis alérgica en el Hospital de La Samaritana entre el 1 de julio del 2010 y el 1 julio del 2011, y que cumplieron los criterios de selección, de los cuales se obtuvieron 34 muestras de lavados nasales posteriores a provocación intranasal con ácaros. Resultados: Los pacientes mostraron mayor tendencia a pertenecer al grupo de síntomas de mayor severidad y frecuencia según la escala ARIA. Los valores de Rantes encontrados en lavados nasales tuvieron un promedio de 8,1 pg/ml (+/– 19DS). Conclusión: Se encontró una positividad en los valores de la citoquina CCL5 en los lavados nasales del 20% de los pacientes. El coeficiente de correlación obtenido muestra una asociación débil.

Objective: Determine the values of Rantes, after exposure to mites, to evaluate its association with ARIA scale in the group of selected patients. Design: Cross sectional survey. Materials and Methods: We included 17 patients presenting with allergic rhinitis at the Samaritan Hospital between July 1, 2010 and July 1, 2011, and met the selection criteria, of which 34 samples were obtained from nasal washes after intranasal challenge with mites. Results: Patients showed a greater tendency to belong to the group of symptoms of greater severity and frequency according to the ARIA scale. Rantes values found in nasal washes had an average of 8.1 pg/ml (+/– 19DS). Conclusions: Positivity was found in the values of the cytokine CCL5 in nasal washes of 20% of patients. The correlation coefficient shows a weak association.

La rinitis alérgica local es una entidad prevalente inducida por alérgenos inhalados estacionales y perennes / Local allergic rhinitis is a prevalent entity induced by seasonal and perennial inhalant allergens

La rinitis alérgica local (RAL) es un nuevo fenotipo de rinitis con producción nasal de anticuerpos IgE específicos en ausencia de atopia sistémica que puede afectar a sujetos previamente diagnosticados de rinitis no alérgica y rinitis idiopática. Esta nueva entidad se caracteriza por la existencia de síntomas clínicos sugestivos de rinitis alérgica, producción local de IgE específica y presencia de un patrón inflamatorio Th2 en la mucosa nasal durante la exposición natural, así como tras la prueba de provocación nasal con alérgenos con producción local de IgE específica, triptasa y proteína catiónica de eosinófilos (ECP). La existencia de esta nueva entidad hace necesaria la realización de un diagnóstico alergológico preciso en pacientes con síntomas sugestivos de rinitis alérgicas cuando el prick test y la determinación de IgE específica sérica sean negativos. La detección local de anticuerpos IgE específicos en las secreciones nasales durante la exposición natural a aeroalérgenos y la respuesta positiva a la prueba de provocación nasal con aeroalérgenos con producción local de triptasa, ECP e IgE específica han demostrado ser una aproximación adecuada para detectar pacientes con RAL.

Estudo aerobiológico da atmosfera de Caxias do Sul em 2007 / Aerobiology study of the atmosphere of Caxias do Sul in 2007

Objetivos: Identificar e quantificar os tipos polínicos na atmosfera de Caxias do Sul e as oscilações estacionais dos grãos de pólen no ano de 2007. Analisar as correlações entre os parâmetros meteorológicos e as concentrações de pólen atmosférico. Métodos: Para a obtenção dos grãos de pólen, foi utilizado o captador volumétrico de sucção tipo Hirst (modelo Burkard) instalado no alto do Hospital Geral, a uma altura aproximada de 20 metros, local este que não apresentam obstáculos aparentes que possam bloquear a chegada de massa de ar. Resultados: Obtivemos como resultados 14.436 grãos de pólen/m3 coletados no ano de 2007. Foram encontradas concentrações máximas mensais bastante diferenciadas, uma na primavera devida, principalmente, a floração de Euphorbiaceae, Urticaceae, Poaceae, Myrtaceae e Carya e outra no inverno que se deve fundamentalmente a floração de plantas arbóreas como Mimosa scabrella, Cupressaceae, Pinaceae, Platanus e Melastomataceae. Em relação aos fatores meteorológicos e as concentrações de pólen liberados pelas plantas, podemos dizer que a temperatura e a precipitação são responsáveis diretos das grandes mudanças quantitativas dos grãos pólen. Conclusões: Os meses de maiores picos polínicos foram setembro com 2.525 grãos/m3 de pólen de Mimosa scabrela, totalizando no ano 3.124 grãos/m3, sendo o tipo polínico de maior concentração no ano de 2007, seguido de Urticaceae com uma concentração no mês de outubro de 542 grãos/m3 e totalizando durante o ano 2.052 grãos/m3 e Cupressaceae que totalizou 655 grãos/m3 em julho e no ano 1.075 grãos/m3.

Objectives: To identify and quantify the pollen types in the atmosphere of Caxias do Sul and the seasonal oscillations of pollen grains during the year 2007 and to analyze the correlations between the meteorological parameters and the concentration of atmospheric pollen. Methods: To obtain the pollen grains, we used the suction volumetric sampler, Hirst type (Burkard model), placed on the roof of the Hospital Geral, at about 20m, because it is a place that does not show any obstacles that can block the air mass. Results: We obtained 14,436 pollen grains/m3 collected in the year of 2007. It was found a very differentiated monthly maximum concentration, one in spring, mainly due to the flowering of Euphorbiacea, Urticaceae, Poaceae, Myrtaceae e Carya and other in winter fundamentally due to the flowering of woody plants such as Mimosa scabrella, Cupressaceae, Pinaceae, Platanus and Melastomataceae. About the relations between the meteorological factors and the concentration of pollen released by plants, we can state that the temperature and the precipitation are the main responsible for the great quantitative changes of pollen grains. Conclusions: The month of the highest pollen peak was September with 2,525 grains/m3 of Mimosa scabrela pollen with a total in the year of 3,124 grains/m3, being the pollen type with the highest concentration in the year of 2007, followed by Urticaceae with a concentration in October of 542 grains/m3 and a total of 2,052 grains/m3 during the year and Cupressaceae in July with a total of 655 grains/m3 and in the year a total of 1,075 grains/m3.

Efectividad del extracto estandarizado de hojas de petasites hybridus (tesalin®) en el tratamiento de la rinitis alérgica / Effectiveness of the standardized extract of leaves of petasites hybridus (tesalin®) in the treatment of allergic rhinitis

La rinitis alérgica es una patología frecuente, de alto impacto social, y alteración de la calidad de vida, lo que conlleva al cambio frecuente de la medicación, y al uso de más de un medicamento, sin el control adecuado de la sintomatología. Se evaluó la evolución de los síntomas clínicos en 927 pacientes con historia de rinitis alérgica perenne y estacional sintomática, sin indicación de antibioticoterapia en las dos semanas previas al tratamiento con Extracto estandarizado de hojas de Petasites Hybridus Ze339 (Tesalin®). Los síntomas de la rinitis alérgica fueron registrados en la visitas a sus médicos los días 0, 7, 14 y 28 después de iniciar el tratamiento. Los pacientes con Extracto estandarizado de hojas de Petasites Hybridus Ze339 (Tesalin®) una tableta dos o tres veces al día durante 28 días, se permitió cualquier otra medicación concomitante excepto antimicrobianos. El análisis de efectividad y tolerancia fue realizado por el médico y paciente. Para el médico, el porcentaje de pacientes que se encontraban totalmente libres de síntomas, o éstos eran muy leves,fue de 94.71%, mientras que para los pacientes fue de 95.90%, con una excelente correlación entre ambas opiniones. La tolerancia fue buena para el médico (90.70%) y para el paciente (94,47%) (p 0.95). El extracto estandarizado de hojas de Petasites Hybridus Ze339 (Tesalin®) resultó efectivo y seguro en el tratamiento de los síntomas de la rinitis alérgica no complicada

Allergic rhinitis is a common condition, high social impact, and impaired quality of life, which leads to frequent change of medication, and the use of more than one drug, without adequate control of symptoms. We evaluated the evolution of clinical symptoms in 927 patients with a history of seasonal allergic rhinitis and symptomatic, with no indication of antibiotic therapy in the two weeks before, that receiving standarized extract of leaves of Petasites Hybridus Ze339 (Tesalin®). The symptoms of allergicrhinitis were recorded in the visits to their doctors on days 0, 7, 14 and 28 after starting treatment. Patients were treated with standarized extract of leaves of Petasites Hybridus Ze339 (Tesalin®) one tablet two or three times a day for 28 days, allowed any concomitant medication except antibiotics. The effectiveness and tolerance analysis was performed by both the physician and patient. For physicians, the percentage of patients who were completely free of symptoms it was very mild, was of 94.71%, while for the patients was 95.90%, with an excellent correlation between both. Tolerance was good for the doctor (90.70%) and patients (94.47%) (P 0.95). The standarized extract of leaves of Petasites Hybridus Ze339 (Tesalin®) is effective and safe in treating the symptoms of allergic rhinitis is not complicated

Diversity and prevalence of airborne fungi isolated from São Luis, Northeast Brazil

Airborne fungi are considerate the main agents related to allergy in patients that suffer from asthma and rinitis. The knowledge about the prevalence of these microorganisms and theis seasonal variation can be useful for human health by improving the diagnosis and treatment of respiratory allergic disease provoked by their inhalation. The present study has isolated and identified airborne funfi from São Luis city investigating their prevalence, biodiversity and seasonal variation. Samples were taken by the Petri plate gravitacional method in six urban areas. A total of 2993 fungal colonies were counted, 67,9% in the dry season and 32,1% in the rainy season. Statistical analysis showed that there are significant diference (p=0,0121) between the averages of spores in dry and rainy periods. Relative humidity, rainfall precipitation and wind speed can have influenced the diversity and concentration of fungal spores presents in the air. Among 24 genera isolated, the most prevalent ones were Aspergillus (38,7)%, Fusarium (13,90%), Curvularia (11,18%) and Penicillium (10,88%), major triggers of allergic process worldwide recognized. The data show the presence of a large number of airborne fungi spores in São Luis and all genera found are opportunistic and they may cause disease in susceptible patients.

Probióticos - Revisão da Literatura / Probiotics - Literature Review

Realizar revisão sobre uso de Probióticos emartigos originais no Pubmed. Resultados: Foram selecionadosartigos que abordavam as características gerais dosprobióticos, bem como seu uso na imunomodulação. Osprobióticos estão indicados na prevenção de diarréias,causadas por antibióticos e rotavírus, mas também emdoenças atópicas, auto-imunes e câncer. O efeito terapêutico,na literatura, foi observado com doses variáveis de 106 a109 UFC e embora seu mecanismo de ação não estejatotalmente estabelecido, o probiótico deve estar viável quandoconsumido, permanecer vivo após contato com suco gástricoe bile, aderir-se à mucosa intestinal e competir commicrorganismos patogênicos, promovendo ação satisfatóriana modulação de inflamação e imunidade. Conclusão: Asbactérias ácidas lácticas promovem melhoria nofuncionamento do organismo, devendo-se realizar maioresestudos, para que sua utilização seja mais ampla em Medicina...

To perform a literature review on probiotics usefrom articles published in Pubmed. Results: Were selectedarticles that addressed general characteristics of probioticsand their use in immunomodulation. Probiotics have beenindicated for the prevention of diarrhea caused by rotavirusand antibiotics, and also atopic diseases, autoimmunediseases and cancer. Therapeutic effect, in literature, wasobserved at doses varying from 106 to 109 CFU, and althoughits mechanism of action has not been fully established, to bebeneficial probiotics must be viable when consumed, remainalive after contact with gastric and bile juice, adhere to theintestinal mucosa and compete with pathogenicmicroorganisms, promoting a satisfactory action in themodulation of inflammation and immunity. Conclusion: Lacticacid bacteria promote improvement in the body’s function.Further studies must be carried out so that probiotics usemay be broadened in medicine...